# Generative Surgical Simulation

NVIDIA released Cosmos3-H-Dreams, moving interactive generative surgical simulation from tabletop suturing to clinical cholecystectomy scenes. The earlier Cosmos-H-Dreams learned visual dynamics on dVRK tabletop suturing without explicitly modeling tissue deformation or contact; the new model trains on CMR Surgical Versius clinical recordings and robot kinematics, builds on Cosmos 3, distills a bidirectional teacher into four-step and two-step causal students, and runs in real time on a single RTX PRO 6000 GPU under kinematic control.

NVIDIA released Cosmos3-H-Dreams, moving interactive generative surgical simulation from tabletop suturing to clinical cholecystectomy scenes. The earlier Cosmos-H-Dreams learned visual dynamics on dVRK tabletop suturing without explicitly modeling tissue deformation or contact; the new model trains on CMR Surgical Versius clinical recordings and robot kinematics, builds on Cosmos 3, distills a bidirectional teacher into four-step and two-step causal students, and runs in real time on a single RTX PRO 6000 GPU under kinematic control.